SURGICAL ACCESS SYSTEM
20210068864 ยท 2021-03-11
Assignee
Inventors
Cpc classification
A61M2205/3341
HUMAN NECESSITIES
A61B17/3462
HUMAN NECESSITIES
A61B18/12
HUMAN NECESSITIES
A61B17/3423
HUMAN NECESSITIES
A61B2017/3466
HUMAN NECESSITIES
International classification
Abstract
A surgical access system, includes a gas insufflation device, a multi-instrument access platform and a surgical smoke evacuation device, wherein the gas insufflation device is connected to a connector of the multi-instrument access platform, and an outlet and an inlet of the multi-instrument access platform are respectively connected to an inflow tube and an outflow tube of the surgical smoke evacuation device.
Claims
1. A surgical access system, comprising an gas insufflation device, a multi-instrument access platform and a surgical smoke evacuation device; wherein the air blowing device is connected to a connector of the multi-instrument access platform, and an outlet and an inlet of the multi-instrument access platform are respectively connected to an inflow tube and an outflow tube of the surgical smoke evacuation device.
2. The surgical access system of claim 1, wherein the multi-instrument access platform comprises an access platform cover or cap and an access tube, and the access platform cover or cap is covered on the access tube; the access platform cover or cap comprises a semi-flexible rubber top cover and a rigid annular frame which are fixed together, at least three instrument channels are arranged on the semi-flexible rubber top cover, and the instrument channels are connected with the semi-flexible rubber top cover through a fold; the rigid annular frame is butted cooperatively with the access tube; the rigid annular frame is further provided with an integrally formed inflation inlet, and an outlet and an inlet on a side of the access platform cover or cap opposite to the inflation inlet; and a variable ratchet is arranged on the access tube, and the variable ratchet is connected with a support ring.
3. The surgical access system of claim 2, wherein one end of the inlet leading to the access tube is connected with a smoke ring evacuation port; the inlet has a lumen diameter gradually decreasing along a direction of entering the access tube; and the outlet has a lumen diameter gradually increasing along the direction of entering the access tube.
4. The surgical access system of claim 2, wherein a rubber flange is arranged on the access tube, an integrally formed conical face is arranged on an inner side of the access platform cover or cap connected with the rigid annular frame, and the conical face is butted cooperatively with the rubber flange.
5. The surgical access system of claim 2, wherein the inflation inlet is a straight tube connected with an inflation valve and the connector connected with the gas insufflation device.
6. The surgical access system of claim 1, wherein the gas insufflation device is a CO.sub.2 medical grade insufflator.
7. The surgical access system of claim 1, wherein the surgical smoke evacuation device comprises a gas storage container which comprises an inflow filter and an outflow filter which are respectively arranged at an inlet hole and/or an outlet hole, and the inflow filter and the outflow filter are respectively connected with the inflow tube and the outflow tube; and the gas storage container further comprises a volume-variable chamber.
8. The surgical access system of claim 7, further comprising a pump arranged on the outflow tube connected with the outflow filter; the pump is powered by an integrated battery or a power supply; and the pump is a variable-speed pump.
9. The surgical access system of claim 7, wherein the inflow tube is connected to the outlet of the multi-instrument access platform, and the outflow tube is connected with the inlet of the multi-instrument access platform; or, the inflow tube is connected with an outlet of the gas insufflation device, and the outflow tube is connected with an inlet of a laparoscopic passage.
10. The surgical access system of claim 7, wherein the gas storage container comprises at least one gas storage bag; the at least one gas storage bag is separated by a pressure-sealed zipper line or combined by a sliding zipper; and the gas storage container is made of medical-grade plastic, cellophane or a biodegradable plastic material.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0021]
[0022]
[0023]
[0024]
[0025]
[0026]
[0027]
[0028]
[0029]
[0030]
[0031]
[0032]
[0033] wherein, 1access platform cover or cap, 2access tube, 3variable ratchet, 4support ring, 5sutural pore, 6pressing latch, 7instrument channel, 8semi-flexible rubber top cover, 9fold, 10rigid annular frame, 11inflation inlet, 12inflation valve, 13connector, 14outlet, 15inlet, 16smoke ring evacuation port, 17operation site, 18pump motor, 19inflow tube, 20gas storage container, 21inflow filter, 22pump, 23outflow filter, 24outflow tube, 25rubber flange, 26conical face, 27insufflator, 28standard sterile flexible tube, 29laparoscope, 30cutting instrument, 31electrosurgical electric knife head, 32abdominal wall, 33multi-instrument access platform, 34gas flow direction, 35human tissue, 36surgical cavity, 37gas storage bag, 38zipper line, and 39sliding zipper.
DETAILED DESCRIPTION
[0034] The disclosure is described in detail hereafter by specific examples in connection with accompanying drawings, so as to help better understand the disclosure, but the following examples do not limit the scope of the disclosure. Moreover, it should be noted that the illustrations provided in the following embodiments only illustrate the basic concept of the disclosure in a schematic way, and the accompanying drawings only show the components related to the disclosure, instead of depicting according to the number, shape and size of the components in actual implementation. The shape, number and proportion of each component can be randomly changed in actual implementation, and the lay-out and modality of the components may be more complex.
Embodiment One
[0035] As shown in
[0036] In an alternative embodiment of the disclosure, the support ring 4 is provided circumferentially with sutural pores 5. The access platform cover or cap 1 is closed on the access tube through a pressing latch 6. The rigid annular frame 10 is made of a hard rubber material. The inflation inlet 11 is a straight tube and is connected with an inflation valve 12 and a connector 13, and the connector 13 is connected with an insufflator.
[0037] As shown in
[0038] As shown in
[0039]
[0040]
[0041] The gas flow evacuation from the smoke ring evacuation port 16 is especially used for promoting the gas flow to move along the axis of the access tube 2, thereby forming a CO.sub.2 flow around the operation site. It is the result of careful experiments and tests that the smoke ring evacuation port is close to the access platform cover or cap 1. This position prevents the smoke ring evacuation port 16 from interfering with the instrument introduced through the instrument channel 7, and also prevents the evacuation from being too close to the tissue of a patient, which may otherwise dry or dehydrate the tissue in extreme cases. The smoke ring evacuation port 16 also has the additional function of heating and humidifying the circulating gas, such as heating the gas inside and outside the insufflator, in the gas storage container or in the pump.
[0042]
[0043]
[0044] As shown in
[0045] The multi-instrument access platform provided by the disclosure can be applied to a system for the laparoscopic surgery or other operations. Compared with the access platform in the prior art, the multi-instrument access platform of the disclosure has the following advantages:
[0046] 1. The multi-instrument access platform includes the support ring, so that the insertion depth of the access tube can be adjusted during the operation, thereby better positioning the access tube according to the lesion position or working more effectively under different rectal conditions (for the rectum that is longer or shorter compared with the general rectum).
[0047] 2. The multi-instrument access platform can remove and reinstall the access platform cover or cap, rotate and reposition the access platform cover or cap and the instrument channel to provide better instrument positioning during surgery, and if a tissue needs to be removed during surgery, the cover can be conveniently removed and installed with one hand.
[0048] 3. The joint between the semi-flexible rubber top cover and the instrument channel of the multi-instrument access platform is presented as a fold, and the instrument and visualization system (laparoscope) can move in a wider range with the fulcrum as the center, while keeping the fixed fulcrum for the instrument pivoting.
[0049] 4. The sealing mechanism of the multi-instrument access platform prevents gas leakage in the pressurized space, the rubber flange in the sealing cover presses the conical face tightly, and the gas pressure in the access tube also exerts extra pressure on the rubber flange, which helps to form a completely sealed access tube.
[0050] 5. The multi-instrument access platform includes an inflation inlet channel for inflation, and another inlet and an outlet that are specially used for forming a vision smoke removal and gas circulation system.
[0051] 6. The outlet channel of the multi-instrument access platform is specially designed as a wide-hole channel, and the inlet channel is gradually narrowed. The narrow end of the inlet channel is connected with an evacuation port which is close to the access platform cover or cap and ejects to the distal end of the access tube, so as to guide the gas to flow in a direction parallel to the access tube and thus form a purging circulation circuit to transfer the gas, smoke and toxic substances from the operation site to a gas storage container equipped with special inflow and outflow filtration systems.
[0052] 7. The multi-instrument access platform further includes a smoke ring evacuation port to guide the gas to flow from the proximal end of the access platform cover or cap to the distal operation site, so as to avoid the potential risk of tissue damage in the surgical cavity. This risk is caused by the drying and cooling effects when cold gas sweeps the human tissue at the operation site, such as drying and dehydration.
[0053] 8. The multi-instrument access platform not only can control different insertion depths and has a rotatable and repositionable access platform cover or cap that can be easily disassembled, but also has three integrated ports on the access platform cover or cap for inflation, smoke evacuation and inflation stabilization.
Embodiment Two
[0054] As shown in
[0055] In an alternative embodiment of the disclosure, the surgical smoke evacuation device includes a pump 22 arranged on the outflow tube 24 connected with the outflow filter 23. The pump 22 is powered by an integrated battery or a power supply. The pump 22 is a variable-speed pump.
[0056] As shown in
[0057] The gas storage container 20 is provided with the outflow filter 23 for other gas flowing out from the inside. The gas enters the pump 22 embedded in the outflow tube 24 through a flexible tube via the outflow filter 23, and then enters the multi-instrument access platform 33 via a connecting piece. A pump motor 18 is connected to push the pump 22 so as to promote the gas flow into the operation site 17 and complete the circuitous flow, and meanwhile the gas containing smoke and harmful smoke plume in its circulation route flows towards the filtered gas storage container 20. The completion of the loop creates a stable gas circulation. The gas carrying smoke and harmful gas is filtered by the inflow filter 21 and the outflow filter 23 and then returned, thereby creating a clear line of sight and a smoke-free environment to complete the surgery. Combined with the stabilizing effect of the gas storage container 20, a stable operation site and instrument are created without bulging.
[0058] Referring now to
[0059] Particularly depending on the operation conditions, the surgeon can choose to connect only the blowing pressure stabilization, only the smoke evacuation circuit or both when noticed the bulging or movement of the tissue, specifically as follows.
[0060] Blowing stabilization: one end of the inflow tube 19 is connected to the outlet 14 of the instrument channel 7, and the other end is connected to the inflow filter 21 and enters the gas storage container 20. Combined with the volume of the gas storage container 20 and the volume of the operation site 17, the increased effective volume will stabilize the pneumoperitoneum. If smoke removal and stabilization are desired after blowing stabilization, the outflow filter 23 is connected to the outflow tube 24 having the pump 22 that is connected to an inlet connection for the inlet 15 of the instrument channel 7, and the pump motor 18 is activated to promote gas flow and complete a degassing loop, so that smoke and steam are transferred from the operation site 17 via the filtered and activated circulation system.
[0061] Now referring to
[0062] The purpose of the disclosure is to provide a surgical smoke evacuation device which can ensure stable pressure and minimum movement of the cavity or cavity wall during surgery, thereby creating a stable operation environment; while allowing the insufflator to maintain safe and effective flow of the insufflated gas in the cavity regardless of the size of the cavity and the leakage amount during surgery.
[0063] An energy source instrument used in the laparoscopic surgery, such as an electrocauterization device, a laser system and an ultrasonic scalpel, produce a gas by-product of aerosol, including viable and non-viable cellular substances. Such operation smoke will blur the operation area and have adverse effects on the human body. Most laparoscopic surgeons focus on maintaining a good line of sight in the operation area, and the most common method is releasing or discharging the smoke into the environment of the operating room. Some medical centers use filters for the surgical smoke, but these filters focus on removing the smoke to keep the surgeon's line of sight, rather than protecting the health of a person in a surgical facility.
[0064] In the conventional laparoscopic surgery, the surgeon will periodically discharge the smoke plume to the atmosphere by opening and closing the laparoscopic access orifice (trocar) or its valve, or in some cases the access orifice is connected to a special smoke removal system, which effectively removes the smoke plume from the abdomen into a specially designed and filtered container.
[0065] In a small cavity in the body, when the electrosurgical technique is used, this smoke accumulation will be further amplified and will seriously limit the completion of certain operations, because the surgeon's line of sight is damaged, and it is generally considered that this smoke accumulation seriously limits the wide application of TATME or TAMIS or other natural orifice transluminal endoscopic surgery techniques.
[0066] Another objective of the disclosure is to create a system, which can remove the smoke generated during the laparoscopic surgery, regardless of the size of the surgical cavity, without affecting the safety during operation of the insufflator as used.
[0067] Another objective of the disclosure is to solve the two independent but related problems of keeping the pneumoperitoneum stable during gas insufflation while evacuating smoke in a simple and cost-effective way.
Embodiment Three
[0068] A surgical access system includes a gas insufflation device, an instrument access platform for entering an operation site as described in Embodiment one, and a surgical smoke evacuation device as described in Embodiment two. An outlet and an inlet of the access platform are connected with a gas storage bag or a gas storage container of the surgical smoke evacuation device, so that the inflation of the system is stabilized. The gas storage container promotes circulation of the smoke through a pump powered by an integrated battery or a power supply, and purges the visual path through a filtering system to prevent the recycling of potentially harmful particulate smoke. The gas insufflation device in the surgical access system is an insufflator, and more preferably a pulse insufflator.
[0069] In some embodiments, the access platform or the surgical smoke evacuation device in the system can function independently of each other. In one embodiment, the multi-instrument access platform provides an improved access path through a natural orifice or an artificial incision, so that the depth into the orifice or the incision can be adjusted and fixed as required, and the instruments and visualization equipment can be easily manipulated. For example, the fold on the multi-instrument access platform which is arranged around the instrument channel on the access platform cover or cap makes the laparoscope and the laparoscopic instruments (scissors, graspers and endoscopic surgical instruments) easier to operate, and a safe and easily controlled pressing latch is used for making the access platform cover or cap easy to fix and disassemble. Furthermore, in the system the access platform cover or cap can be rotated during placement or surgery, and can be adjusted flexibly by the user according to the operation condition, the patient's anatomy condition or the user's preference.
[0070] In another embodiment, any one of the multi-instrument access platform and the surgical smoke evacuation device in the surgical access system is connected with the traditional laparoscopic channel (sometimes called a puncture outfit) to independently maintain the pneumoperitoneum and/or evacuate the smoke. As shown in
[0071] In another embodiment, when connected to the insufflator and the luer connector or other connectors of the conventional laparoscopic channel (instead of connecting to the novel instrument channel), the gas storage container 20 together with the existing inflow tube 19, outflow tube 24, pump 22, inflow filter 21 and outflow filter 23 will form a smoke evacuation circuit for the conventional laparoscopic surgery.
[0072] In a further embodiment, the outlet 14 of the multi-instrument access platform is connected with the inflow tube 19 made of silica gel or other inflow tubes with similar soft inner cavities. The inflow tube 19 delivers gas and toxic smoke to the gas storage container 20. The main function of the gas storage container 20 is to inflate and pressurize the cavity by increasing and expanding the effective volume according to the principle explained in Embodiment one. An incoming carbonized gas containing microorganisms enters the inflow filter 21 through the inflow tube 19 to filter the gas and smoke plume, and then is delivered into the gas storage container 20. The filtered gas then passes through the outflow filter 23, and is delivered into the inlet 15 of the multi-instrument access platform through the outflow tube 24 made of silica gel under the action of a special pump 22 (shown as a single pump which can be disposable or reusable) powered by a battery or a power supply. Under the acceleration effect of the smoke ring evacuation port of the multi-instrument access platform, the gas removes the smoke around the operation site at the distal end of the access tube of the instrument access platform. In this process, through the smoke evacuation and filtration system of the surgical access system, the smoke generated by the electrosurgical operation can be continuously circulated, and meanwhile the pneumoperitoneum can be kept stable.
[0073] The above content is a further detailed description of the disclosure in connection with the specific preferred embodiments. It cannot be considered that the implementation of the disclosure is limited to the description. For those skilled in the art to which the disclosure belongs, on the premise of not departing from the conception of the disclosure, several equivalent substitutions or obvious modifications with the same performance or use can also be made, which should be regarded as belonging to the claimed scope of the disclosure.